Apr 18 Reviving Healthcare on the Hill

Last Monday, Republican legislators met to discuss efforts to repeal the Affordable Healthcare Act (ACA). Last month the proposed healthcare legislation,the American Health Care Act, was pulled from the House due to a lack of support from conservative Republicans and a majority of Democrats. The Washington Post reported on Tuesday, April 4th, that Vice President Mike Pence, Chief of Staff Reince Priebus, and Budget Director Mick Mulvaney traveled to Capitol Hill late Monday to attend a meeting held by a conservative faction of the Republican Party, the Freedom Caucus, to discuss a proposal with hopes of creating a compromise on health care within the Republican party. [1]. The proposal will allow states to apply for federal waivers which will exempt them from some of the mandates under the ACA. The ACA currently requires a “community rating” on insurers. The rating system prevents insurers from segregating healthy subscribers from sick subscribers in order to charge those who are sick higher premiums. The proposed provision, which would bar insurers from charging the healthy less than the sick on their premiums, includes the “essential health benefits” which require coverage of mental health care, substance abuse treatment, maternity care, prescription drugs, and more, [1].

Several conservatives hold that the community rating requirement has driven up premiums for those who are healthy and need to be either eliminated or decreased. Alternatively, moderate Reps. believe that the elimination or decrease of the community rating provision would make insurance unaffordable to the sick. Moreover, such a provision would betray Trump’s campaign promise to not discriminate against those with preexisting medical conditions.

The Trump administration and conservative Republicans remain positive that they can repeal and replace the ACA with their new healthcare proposal. By creating a system where the states could apply for a waiver from the Department of Health and Human Services those in the Trump administration and others who back the bill hope they are building a bill which both those in the Republican party will support but will also sway moderate Democrats.

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